Contract Negotiation Manager - PA, DE, NY, NJ, MD, or Washington, DC

CVS Health Corporation; Northern (KY); Hybrid; USD 66,000 - 146,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Comprehensive benefits package

Job summary

CVS Health Corporation is seeking a seasoned healthcare contracts professional to negotiate and execute complex provider contracts, ensuring network adequacy, regulatory compliance, and cost efficiency across national and regional initiatives.

You will collaborate cross-functionally with network management, pricing, and health plan teams, lead contracting activities from receipt to signature, and support expansion initiatives for behavioral health networks.

Qualifications

• 5+ years in network contracting and provider relationships.
• 3-5 years of complex negotiating and decision-making at market/national level.
• Knowledge of managed care, reimbursement models and contracting best practices.

Responsibilities

• Negotiate, execute and review contracts with large providers and networks.
• Support network expansion goals and ensure accessibility and quality targets.
• Collaborate cross-functionally on contracting, pricing, and reimbursement modeling.

Skills

Provider contracting

Network management

Negotiation

Regulatory knowledge

Data analysis

Excel

PowerPoint

Stakeholder management

Behavioral health

Education

Bachelor's degree

Tools

Excel

PowerPoint

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger– helping to simplify health care one person, one family and one community at a time.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Position Summary

Negotiates, executes, conducts high level review and analysis of dispute resolution and/or settlement negotiations of contracts with larger and more complex, market/regional/national based group/system providers including but not limited to individual and group behavioral health providers, etc. in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives. Recruit providers as needed to ensure attainment of network expansion goals, achieve regulatory and/or internal adequacy targets. Support health plan with expansion initiatives or other contracting activities as needed Initiates, coordinates and owns contracting activities to fulfillment including receipt and processing of contracts and documentation and pre- and post-signature review of contracts and language modification according to Aetna’s established policies. Responsible for auditing, building, and loading contracts, agreements, amendments, and/or fee schedules in contract management systems per Aetna established policies. Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Provides Subject Matter Expertise for questions related to recruitment initiatives, contracting, provider issues/resolutions, related systems and information contained. Understanding of Value-Based contracting and negotiations. Preparing reports and presenting to Network Management leadership Engage with providers and move quickly through contracting processes to ensure network adequacy standards are met.

Required Qualifications

• 5+ years of healthcare experience in network contracting and provider relationship management.
• 3-5 years of solid negotiating and complex decision‑making skills while executing national, regional, or market level strategies.
• Demonstrated knowledge of the managed care industry, including reimbursement models, regulatory requirements, and contracting best practices.
• Working knowledge of behavioral health topics related to managed care plans.
• Advanced proficiency in Microsoft Office Suite, particularly Excel (e.g., data analysis, modeling, reporting) and PowerPoint (e.g., executive presentations).
• Proven ability to build and maintain collaborative provider relationships and partner cross‑functionally to resolve complex contract or network issues, with examples of successful issue resolution or stakeholder alignment.
• Candidates must reside in PA, DE, NY, NJ, MD, or Washington, DC

Preferred Qualifications

• Health plan experience supporting behavioral health provider networks.
• General knowledge of reporting tools for contract financial analysis and modeling.
• Demonstrated decision‑making skills while executing national, regional and market level strategies.
• Possess critical thinking, issue resolution and interpersonal skills.
• Strong critical thinking and problem‑solving abilities, with a track record of resolving complex issues and driving effective solutions.
• Excellent interpersonal and communication skills, including the ability to clearly convey complex information both verbally and in writing to diverse stakeholders.

Education

Bachelor's degree or equivalent professional work experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $66,330.00 - $145,860.00 This pay range represents the base hourly rate or base annual full‑time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay range listed above.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 11/30/2026.

Equal Employment Opportunity

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Our Work Experience

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self‑disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.